<form name="form1" method="post" action="">
  <table width="100%" cellpadding="3">
    <tr>
      <td>Employer name </td>
      <td><input name="employer_name" type="text" id="employer_name"></td>
    </tr>
    <tr>
      <td>ABN</td>
      <td><input name="abn" type="text" id="abn"></td>
    </tr>
    <tr>
      <td>Contact name </td>
      <td><input name="contact_name" type="text" id="contact_name"></td>
    </tr>
    <tr>
      <td>Phone</td>
      <td><input name="phone" type="text" id="phone"></td>
    </tr>
    <tr>
      <td>Fax</td>
      <td><input name="fax" type="text" id="fax"></td>
    </tr>
    <tr>
      <td>Address</td>
      <td><input name="address1" type="text" id="address1"></td>
    </tr>
    <tr>
      <td>&nbsp;</td>
      <td><input name="address2" type="text" id="address2"></td>
    </tr>
    <tr>
      <td>&nbsp;</td>
      <td><input name="address2" type="text" id="address2"></td>
    </tr>
    <tr>
      <td>Suburb or town </td>
      <td><input name="town" type="text" id="town"></td>
    </tr>
    <tr>
      <td>Postcode</td>
      <td><input name="postcode" type="text" id="postcode"></td>
    </tr>
    <tr>
      <td>Email</td>
      <td><input name="email" type="text" id="email"></td>
    </tr>
    <tr>
      <td>Password</td>
      <td><input name="password" type="text" id="password"></td>
    </tr>
    <tr>
      <td>Confirm password </td>
      <td><input name="confirm_password" type="text" id="confirm_password"></td>
    </tr>
    <tr>
      <td>&nbsp;</td>
      <td><input type="submit" name="Submit" value="Register">
      <input type="submit" name="Submit2" value="Cancel">
      <input type="reset" name="Submit3" value="Reset"></td>
    </tr>
  </table>
</form>
